Flashcards in Qbank Deck (479)
One anatomical difference between pilonidal disease and perianal abscess? Suppurative hidradenitis vs pilonidal?
Perianal will be at the anal verge
Pilonidal will be over the coccyx superior to the anus
Suppurative hidradenitis is usually in axilla or groin not anus/coccyx
A patient 2 weeks post op of a partial gastrectomy presents with postprandial abdominal cramps, weakness, diaphoresis 30 minutes after eating- diagnosis and treatment?
Dumping syndrome- rapid emptying of stomach leads to fluid shift and autonomic reflexes
Tx is dietary changes 1st, octreotide if refractory
Preferred way to establish airway in patient with C spine injury?
Orotracheal intubation after stabilizing C spine
A patient presents with edema, hypoalbuminemia, and proteinuria- what does this do to the patient's lipid profile?
Increased LDL, low HDL--> increased risk of accelerated atherosclerosis
Treatment for acute dystonic reaction?
Benzotropine or benadryl
Treatment for akathisia?
Treatment for Drug induced parkinsonism?
Amantadine or benzotropine
A demented patient has pneumonia 2/2 aspiration- likely pathogenesis?
Impaired epiglottic reflex
A 18 month old has atopic dermatitis, gets treatment, then has umbilicated vesicles erupt over each cheek with submandibular adenopathy- diagnosis? What virus? Tx?
Eczema herpeticum- occurs over healed atopic dermatitis, HSV, acyclovir
Isoniazid is known for causing vitamin B6 deficiency but can also cause what side effect?
Hepatitis- will see panlobular mononuclear infiltration and hepatic cell necrosis
What rash typically SPARES the diaper region in infants? Is symmetric everywhere else
How should you treat tachycardia with narrow QRS complexes and retrograde P waves?
Adenosine- tx for svt
A patient with TB presents with hyponatremia and hyperkalemia and normal anion gap metabolic acidosis- diagnosis?
Primary adrenal insufficiency- TB is a common cause in developing world
A patient with sickle cell presents for their 6th pain crisis hospitalization- what will be seen on peripheral smear besides sickle cells?
Howell Jolly bodies- at this point the patient has functional asplenia due to autoinfarction
A patient presents with sticking sensation in her throat accompanied by dysphagia and absent peristaltic waves in the lower 2/3 of the esophagus with decreased LES tone- diagnosis?
Scleroderma- no other pathology has absent peristaltic waves
Achalasia has increased LES tone
GERD has peristalsis
What class of medication can inhibits autonomic thermoregulation?
typical antipsychotics such as fluphenazine and haloperidol
How can blood gas differentiate COPD from CHF?
CHF- respiratory alkalosis
COPD- respiratory acidosis
What adrenergic therapy can treat hyperkalemia?
Albuterol and beta 2 agonists
A patient presents with pericarditis and BUN of 96, Cr of 5.1- next step?
Dialysis- this is treatment for uremic pericarditis
An immunocompromised patient has diffuse bilateral interstitial infiltrates on CXR- diagnosis
A patient presents with trendelenburg gait- what muscles or nerves could be injured?
Gluteus medius and minimus innervated by superior gluteal nerve
An HIV patient with esophagitis does not get better following fluconazole treatment- next step?
Get biopsy of ulcers showing CMV-large irregular ulcers or HSV- small, well circumscribed ulcers
CMV gets ganciclovir
HSV gets acyclovir
What lab abnormalities are seen with lupus anticoagulant and why is this interesting?
PTT will be prolonged although patient will be hypercoaguable
Russell viper venom test is specific for lupus anticoagulant and will be prolonged
What is a marjolin ulcer?
non-healing burn wound which becomes squamous cell carcinoma
Management of metastatic brain lesions? USMLE High Yield!
If solitary with stable extracranial disease- surgery
If multiple- whole brain radiation
What is the pathogenesis of aspirin sensitivity syndrome? USMLE High Yield!
Pseudo-allergic reaction due to accumulation of prostaglandins and leukotrienes
What is one method of preventing febrile nonhemolytic reaction after blood transfusion
A patient has hypotension and back pain after cardiac cath that mildly improves with IV fluids- next step?
CT of abdomen to look for retroperitoneal bleeding
How does a knee-to-chest position help during a child's tet spell with TOF?
Increased systemic vascular resistance--> increased pulmonary blood flow